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Cases of Azygous Coil Extraction

BACKGROUND: Procedural and clinical outcomes of patients undergoing extraction or removal of azygous coils are not well characterized. OBJECTIVE: Evaluate outcomes in patients who undergo device extraction with an azygous coil in situ. METHODS: Patients undergoing extraction with an azygous coil in...

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Autores principales: Sampognaro, James R., Lewis, Robert K., Black-Maier, Eric, Pokorney, Sean D., Hegland, Donald D., Piccini, Jonathan P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859796/
https://www.ncbi.nlm.nih.gov/pubmed/35243437
http://dx.doi.org/10.1016/j.hroo.2021.12.004
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author Sampognaro, James R.
Lewis, Robert K.
Black-Maier, Eric
Pokorney, Sean D.
Hegland, Donald D.
Piccini, Jonathan P.
author_facet Sampognaro, James R.
Lewis, Robert K.
Black-Maier, Eric
Pokorney, Sean D.
Hegland, Donald D.
Piccini, Jonathan P.
author_sort Sampognaro, James R.
collection PubMed
description BACKGROUND: Procedural and clinical outcomes of patients undergoing extraction or removal of azygous coils are not well characterized. OBJECTIVE: Evaluate outcomes in patients who undergo device extraction with an azygous coil in situ. METHODS: Patients undergoing extraction with an azygous coil in situ between May 2015 and January 2021 were included in this retrospective single-center analysis. Outcomes included procedural success, use of laser and mechanical cutting tools during the procedure, procedural complications, and mortality. RESULTS: We identified 2 patients undergoing device extraction with an azygous coil in situ with a dwell time greater than 12 months. The patients were male, aged 73 and 83 years. Both had a history of hypertension, atrial fibrillation, heart failure (ejection fractions <15% and 20%), and cardiomyopathy (nonischemic and ischemic), and presented with an infection (case 1 with a single-chamber ICD and Staphylococcus aureus bacteremia, case 2 with a cardiac resynchronization therapy defibrillator pocket infection). The mean dwell time of all 6 leads extracted was 6.43 years (range 1.33–12.63 years), and the 2 azygous coils had dwell times of 1.33 and 6.04 years. In case 1, the azygous coil was inferior to the cardiac silhouette, while in case 2 it was superior. A 14F laser sheath was employed to remove both azygous coils. Both extractions were a complete procedural success in which all leads were removed completely without intraoperative complications. CONCLUSION: These cases demonstrate the variable courses of azygous coils, provide proof of concept that they can be removed safely, and illustrate that azygous coils can be removed with the same techniques that are commonly used to remove other types of leads.
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spelling pubmed-88597962022-03-02 Cases of Azygous Coil Extraction Sampognaro, James R. Lewis, Robert K. Black-Maier, Eric Pokorney, Sean D. Hegland, Donald D. Piccini, Jonathan P. Heart Rhythm O2 Clinical BACKGROUND: Procedural and clinical outcomes of patients undergoing extraction or removal of azygous coils are not well characterized. OBJECTIVE: Evaluate outcomes in patients who undergo device extraction with an azygous coil in situ. METHODS: Patients undergoing extraction with an azygous coil in situ between May 2015 and January 2021 were included in this retrospective single-center analysis. Outcomes included procedural success, use of laser and mechanical cutting tools during the procedure, procedural complications, and mortality. RESULTS: We identified 2 patients undergoing device extraction with an azygous coil in situ with a dwell time greater than 12 months. The patients were male, aged 73 and 83 years. Both had a history of hypertension, atrial fibrillation, heart failure (ejection fractions <15% and 20%), and cardiomyopathy (nonischemic and ischemic), and presented with an infection (case 1 with a single-chamber ICD and Staphylococcus aureus bacteremia, case 2 with a cardiac resynchronization therapy defibrillator pocket infection). The mean dwell time of all 6 leads extracted was 6.43 years (range 1.33–12.63 years), and the 2 azygous coils had dwell times of 1.33 and 6.04 years. In case 1, the azygous coil was inferior to the cardiac silhouette, while in case 2 it was superior. A 14F laser sheath was employed to remove both azygous coils. Both extractions were a complete procedural success in which all leads were removed completely without intraoperative complications. CONCLUSION: These cases demonstrate the variable courses of azygous coils, provide proof of concept that they can be removed safely, and illustrate that azygous coils can be removed with the same techniques that are commonly used to remove other types of leads. Elsevier 2021-12-28 /pmc/articles/PMC8859796/ /pubmed/35243437 http://dx.doi.org/10.1016/j.hroo.2021.12.004 Text en © 2022 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical
Sampognaro, James R.
Lewis, Robert K.
Black-Maier, Eric
Pokorney, Sean D.
Hegland, Donald D.
Piccini, Jonathan P.
Cases of Azygous Coil Extraction
title Cases of Azygous Coil Extraction
title_full Cases of Azygous Coil Extraction
title_fullStr Cases of Azygous Coil Extraction
title_full_unstemmed Cases of Azygous Coil Extraction
title_short Cases of Azygous Coil Extraction
title_sort cases of azygous coil extraction
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859796/
https://www.ncbi.nlm.nih.gov/pubmed/35243437
http://dx.doi.org/10.1016/j.hroo.2021.12.004
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